Question: Over the years, several of my colleagues and I have been the subject of investigations by the Michigan Department of Licensing and Regulatory Affairs. In most of these cases it’s hard to imagine why LARA is expending the time and resources on an investigation. Can you explain how LARA decides which cases it investigates? Does the Board of Dentistry play a role in this process?
Answer: The process leading to most investigations begins with someone filing an allegation to LARA. An allegation can be filed by anyone electronically using the LARA website. Patients, ex-employees, insurers, dental plans, and other dentists are often the people filing allegations. The state of Michigan itself also sometimes files allegations against health professionals — for example, when a prescriber’s Michigan Automated Prescription System report reveals a troubling prescribing pattern, what looks like unauthorized prescriptions, etc.
MCL 333.16231 provides that filed allegations must be reviewed by LARA. Generally, if LARA’s review of an allegation causes it to determine that there is a reasonable basis to believe that a violation of Michigan’s Public Health Code or rules promulgated pursuant to the Public Health Code occurred, LARA must investigate if:
- A panel of at least three Board members including the Board of Dentistry chair authorizes the investigation.
- The Board of Dentistry fails to act upon LARA’s request for authorization for an investigation within seven days of receipt of the request.
- LARA believes immediate jeopardy exists and its director authorizes an investigation and notifies the Board of Dentistry chair of the investigation within two business days.
- The allegation concerns a licensee whose record includes one substantiated allegation, or two or more written investigated allegations, from two or more different individuals or entities, received in the preceding four years.
A couple of other technical points are worth noting about when LARA investigates licensees. LARA must investigate a licensee if it receives information indicating that the licensee has three or more malpractice settlements, awards, or judgments against the licensee in a period of five consecutive years, or one or more malpractice settlements, awards, or judgments against the licensee totaling more than $200,000 in a period of five consecutive years, whether or not a judgment or award is stayed pending appeal. LARA is not required to investigate allegations filed more than four years after the date of the incident or activity that is the basis of the alleged violation.
As you can see, investigations are sometimes mandatory and other times are permissive. In addition, whether LARA may proceed with an investigation of a licensee on its own or must first have the authorization of a panel consisting of the chair of the Board of Dentistry and two other Board of Dentistry members also varies depending on the circumstances.
Something to bear in mind when pondering why LARA is investigating a licensee is the fact that LARA may (and often does) possess more information than you may have regarding the licensee. This additional information could include non-public information contained in the allegation concerning the licensee’s actions/inaction, the licensee’s history of previous allegations (and whether those have been investigated, substantiated, etc.), the licensee’s malpractice history, and so on.
As we all know, sometimes things are not exactly as they appear on the surface, based only on the publicly available information.
This article originally appeared in the May 2025 edition of the Journal of the Michigan Dental Association.
